Aetna Medicare Premier Plan (PPO) By Aetna Medicare

Aetna Medicare Premier Plan (PPO) is a 2014 Medicare Advantage ("Part C" or "MA Plan") plan by Aetna Medicare. This plan from Aetna Medicare works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for Aetna Medicare Premier Plan (PPO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Aetna Medicare and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.

Coverage Area for Aetna Medicare Premier Plan (PPO)

COMPARE AND SAVE ON MEDICARE INSURANCE

The Aetna Medicare Premier Plan (PPO) H5521-033 is available to residents in Florida, and has a in-network Maximum Out-of-Pocket limit of $6,700 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in Aetna Medicare Premier Plan (PPO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $6,700 This is a very nice safety net. This plan includesadditional Medicare prescription drug (Part-D) coverage.

Aetna Medicare Premier Plan (PPO) is a Local PPO. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Ratings for Aetna Medicare Premier Plan (PPO) H5521

2014 Overall Rating

Part C Summary Rating

Total Experience Rating

Complaints, Improvements

Total Customer Service Rating

Total Preventative Rating

Chronic And Long Term Care

Member Experience Rating for Aetna Medicare Premier Plan (PPO)

Total Experience Rating

Getting Needed Care

Timely Care and Appointments

Customer Service

Health Care Quality

Rating of Health Plan

Care Coordination

Member Complaints, Problems Getting Service and Improvements in Health Plans

Total Rating

Members Leaving the Plan

Complaints about Health Plan

Access to Service

Performance Problems

Health Plan Quality Improvement

Customer Service Rating for Aetna Medicare Premier Plan (PPO)

Total Customer Service Rating

Timely Decisions About Appeals

Reviewing Appeals Decisions

Call Center

Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating

Breast Cancer Screening

Colorectal Cancel Screening

Cardiovascular Screening

Diabetes Care

Glaucoma Testing

Annual Flu Vaccine

Improving Physical

Improving Mental Health

Monitoring Physical Activity

Adult BMI Assessment

Ratings For Managing Chronic And Long Term Care

Total Rating

Medication Review

Functional Status Assessment

Pain Screening

Osteoporosis Management

Diabetes Care - Eye Exam

Diabetes Care - Kidney Disease

Diabetes Care - Blood Sugar

Diabetes Care - Cholesterol

Controlling Blood Pressure

Rheumatoid Arthritis

Improving Bladder Control

Reducing Risk of Falling

Plan - Cause Readmissions

Part-C Premium

Aetna Medicare plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

Part-D Deductible and Premium

The Aetna Medicare Premier Plan (PPO) plan has a monthly drug premium of $35.00 and a $310.00 drug deductible. This Aetna Medicare plan offers a $35.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Aetna Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $35.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.

Premium Assistance

Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Aetna Medicare Premier Plan (PPO) medicare insurance plan offers a $12.90 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $18.40 for 75% low income subsidy $23.90 for 50% and $29.50 for 25%.

Part C Premium:

$0.00

Part D (Drug) Premium:

$35.00

Part D Supplemental Premium

$0.00

Total Part D Premium:

$35.00

Drug Deductible:

$310.00

Tiers with No Deductible:

0

Benchmark:

not below the regional benchmark

Type of Medicare Health Plan:

Basic Alternative

Drug Benefit Type:

Basic

Full LIS Premium:

$12.90

75% LIS Premium:

$18.40

50% LIS Premium:

$23.90

25% LIS Premium:

$29.50

Inital Coverage Limit:

$2850

Gap Coverage:

No Gap Coverage

Gap Coverage

In 2014 once you and your plan provider have spent $2,850 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be require to pay 47.5% of the plan's cost for covered brand-name prescription drugs and 72% of the cost for generic drugs unless your plan offers additional coverage. This Aetna Medicare plan offers No Gap Coverage through the gap.
No Gap Coverage means 0% of formulary drugs are covered through the gap or 15 or less brand name products are covered through the gap.